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Quantifying visual allodynia across migraine subtypes: the Leiden Visual Sensitivity Scale
Matthijs J L Perenboom1, Amir H Zamanipoor Najafabadi1, Ronald Zielman1
1Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.
Pain
|July 18, 2018
Summary
Migraine patients often experience visual allodynia, a heightened sensitivity to light and patterns. A new scale, the Leiden Visual Sensitivity Scale (L-VISS), effectively quantifies this sensitivity across different migraine types and states.
Area of Science:
- Neurology
- Ophthalmology
- Psychophysics
Background:
- Visual allodynia, including photophobia and pattern sensitivity, is a common yet poorly quantified symptom in migraine.
- Understanding visual allodynia variations across migraine subtypes and states is crucial for effective management.
Purpose of the Study:
- To develop and validate the Leiden Visual Sensitivity Scale (L-VISS) for quantifying visual sensitivity to light and patterns.
- To assess and compare visual allodynia in various migraine subtypes (episodic/chronic, with/without aura) and states (ictal/interictal).
Main Methods:
- Development of the 9-item L-VISS (score range 0-36) based on literature and patient interviews.
- Validation of L-VISS construct validity and test-retest reliability.
- Assessment of visual sensitivity in episodic migraine (n=133), chronic migraine (n=39), and healthy controls (n=86) using L-VISS and other tests.
- Statistical analysis using a linear mixed model to identify factors influencing visual sensitivity.
Main Results:
- The L-VISS demonstrated good test-retest reliability and construct validity, correlating with light discomfort and pattern glare tests.
- Significantly higher L-VISS scores were observed in migraine with aura versus without aura, and in chronic versus episodic migraine.
- All tested factors (chronicity, aura presence, ictal/interictal state) significantly impacted visual sensitivity scores (P < 0.001).
Conclusions:
- The L-VISS is a reliable and valid tool for quantifying and monitoring bothersome visual sensitivity in large populations.
- Significant differences in visual allodynia exist across migraine subtypes and states, suggesting dynamic changes in cortical excitability.
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